Aims and objectives To assess the level of stress response, self‐efficacy and perceived social support status of working nurses during the outbreak of the COVID‐19 and investigate potential factors affecting their stress. Background The stress level of clinical nurses directly affects their physical and mental health and work efficiency. Design This study was a cross‐sectional investigation, which was performed following the STROBE checklist. The current study was conducted in February 2020 by selecting clinical nurses from the Zigong First People's Hospital for investigation. Methods At the peak of the COVID‐19 outbreak in China, we assessed clinical nurses with the Stanford Acute Stress Reaction Questionnaire, the General Self‐Efficacy Scale and the Perceived Social Support Scale. Specifically, the nurses were divided into three groups: (a) nurses supporting Wuhan; (b) nurses in the department of treating the COVID‐19 patients in our hospital (epidemic department); and (c) nurses in the general department without the COVID‐19 patients in our hospital (non‐epidemic department). Results A total of 1092 clinical nurses were surveyed with 94 nurses in Wuhan, 130 nurses treating COVID‐19 patients in our hospital and 868 nurses working without direct contact with diagnosed COVID‐19 patients. The mean stress score of all surveyed nurses was 33.15 (SD: 25.551). There was a statistically significant difference in stress response scores between different departments. Noticeably, the nurses who went to support in Wuhan showed a weaker stress response than the nurses who stayed in our hospital (mean: 19.98 (Wuhan) vs. 32.70 (epidemic department in our hospital) vs. 34.64 (non‐epidemic department in our hospital)). In addition, stress was negatively correlated with general self‐efficacy and perceived social support. Conclusion The present study suggested that the stress status of second‐line nurse without direct contact with diagnosed COVID‐19 patients was more severe than that of first‐line nurses who had direct contact with COVID‐19 patients. Relevance to clinical practice Our study indicated the importance of psychological status of second‐line medical staff during the global pandemic.

Background: High prevalence of smartphone addiction among medical students may contribute to adverse physical and mental health outcomes. Aim: To estimate the prevalence of smartphone addiction, and explore the influencing factors and related mental health symptoms of smartphone addiction among Asian medical students. Design: Systematic review and meta-analysis. Methods: PubMed (MEDLINE), the Cochrane Central Register of Controlled Trials, and EMBASE were searched for relevant literature from the inception to September 10, 2021. Using Stata software 11.0, the meta-analysis of prevalence and the influencing factors of smartphone addiction were determined with 95% confidence intervals. Results: Nineteen articles, published between 2014 and 2019, were included, producing medical student studies from seven different Asian countries. The included studies were conducted in India ( n = 11) and Malaysia ( n = 3), with China, Saudi Arabia, Turkey, Nepal, and Iran each contributing one study. Among a total of 5,497 medical students, the participants included 3,214 females, of whom 2,181 were medical students with smartphone addiction. The prevalence of smartphone addiction among Asian medical students was 41.93% (95% CI [36.24%, 47.72%]). The influencing factors of smartphone addiction among medical students included gender, duration of smartphone use, smartphone function, and marital status. Ten studies (52.63%) explored related mental health symptoms of smartphone addiction among Asian medical students. Smartphone addiction was positively correlated with poor sleep quality ( r = .17–.31), stress ( r = .30–.40), anxiety, depression, neuroticism, and general health among Asian medical students. Conclusion: Smartphone addiction is highly prevalent among Asian medical students. Smartphone addiction may adversely affect mental health, resulting in sleep disturbance, stress, anxiety, depression, and neuroticism. It is necessary to take appropriate precautionary actions and interventions to prevent smartphone overuse among medical students.

Aim: To investigate the quality of work-life among nursing managers in China and analyse the relationships between self-efficacy, coping style and quality of work-life.Background: Self-efficacy, coping-style and quality of work-life play significant roles in the stability of nursing teams, the quality of clinical care and patient safety.Although some factors influencing quality of work-life have been identified, there is no large-scale study of the relationships among self-efficacy, coping style and quality of work-life of nursing managers. Strategies to strengthen the quality of work-life of nursing managers should be developed by exploring the relationships between the three variables.Methods: A nationwide cross-sectional study was conducted. A total of 1498 nursing managers from 51 tertiary general hospitals in 20 provinces in China were selected for the study using multistage stratified proportional sampling. Registered full-time nursing managers with more than 1 year of management experience were eligible for the study. The participants completed online questionnaires to assess their self-efficacy, coping style and work-related quality of life. The data were analysed using descriptive analysis, Pearson's correlation, hierarchical multiple linear regression and structural equation modelling to verify the relationships between variables. Results:The quality of work-life score for the nursing managers surveyed was 3.74 AE 0.56 out of a possible 5. Self-efficacy was positively correlated with quality of work-life (β = .484, P < .01) over all demographic variables. Positive coping was also positively associated with quality of work-life (β = .404, P < .01). Self-efficacy and positive coping explained 22.7% and 14.2% of the variance in the quality of work-life, respectively. Structural equation modelling indicated that self-efficacy positively and directly predicted the quality of work-life (β = .395, P < .001), and indirectly affected quality of work-life via positive coping (β = .186, P < .001), but not via negative coping (β = .005, P > .05). The final model could explain 44% of the variance in the quality of work-life.

Objectives: To compare the hematologic, blood chemistry, and coagulation test results between two blood sampling methods via central venous access devices (CVADs) and venipuncture. Method: The authors searched PubMed, Embase, Cochrane, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) for controlled studies that compared the differences in hematologic, blood chemistry, and coagulation test results between venipuncture and CVADs from the date of database establishment to July 2022. Two researchers independently performed the literature screening, data extraction, and quality assessment. The standardized mean difference was used as the effect size for continuous variables and a 95% confidence interval was provided. The random-effects model was used for an I2 > 50%, otherwise the fixed-effects model was used. Sources of heterogeneity were determined by subgroup analysis or sensitivity analysis, as indicated. Results: This review ultimately identified 17 studies for systematic review, of which 12 were selected for meta-analysis. A total of 541 adult participants were included in the meta-analysis. With the exception of the activated partial thromboplastin time, there were no significant differences in hematologic, blood chemistry, and coagulation test results between blood sampling via venipuncture and CVADs. Conclusions: The results of this study provide substantial evidence that blood sampling via venipuncture and CVADs had equal reliability in most laboratory tests. Serial blood sampling via CVADs will reduce the risk of bleeding episodes and pain at the blood collection site, and safety for healthcare professionals.

Background: Falls are serious public health problems associated with irreversible health consequences and substantial economic burden. To effectively reduce the incidence of falls and mitigate fall-related injuries, we designed and verified a multifactorial fall intervention model.Methods: The current study was a longitudinal before-and-after controlled investigation including 3 phases with clinical characteristics of fall patients retrospectively identified in phase 1, a multifactorial fall intervention model designed in phase 2 and prospectively evaluated in phase 3. Phase 1 and 2 were conducted based on 153,601 hospitalized patients between January 2015 and December 2016. Phase 3 was carried out based on 171,776 hospitalized patients between January 2017 and December 2018. The Pearson Chi-squared test was used to compare categorical variables and the Mann-Whitney non-parametric test was utilized for one-way ordered data.Results: In phase 1, baseline characteristics of 491 fall patients revealed that inpatients falls were highly associated with the age, medication and disease. In phase 2, a new multifactorial fall intervention model covering measures for fall prevention, fall-onset management and continuous improvement was developed. Phase 3 recorded a total of 396 falls and demonstrated a remarkably declined fall rate (Reduction in falls by 0.09%, p<0.001) and fall rate per 1000 patient-days (Reduction in falls/1000 patient-days by 0.07‰, p<0.001) as compared with phase 1. The adjusted incident rate ratio of fall was 1.443 (95%CI: 1.263-1.647) (Phase 1 vs. Phase 3). Furthermore, the occurrence and the severity of fall injuries in phase 3 were significantly lower than that in phase 1 (Z=-4.426, p<0.001). More specifically, the number of uninjured falls accounted for 42.42% in phase 3 in comparison of 32.99% in phase 1.Conclusions: This multifactorial fall intervention model exhibited favorable effect on reducing the occurrence of fall and fall injuries.

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